Topical skin therapeutics Flashcards
What are the advantages to topical treatments?
Direct application
Reduced systemic effects
What are the disadvantages to topical treatments?
Time consuming
Correct dosage difficult
Messy to use
What are the different types of vehicles?
Gels Creams Ointments Pastes Lotions Foams
What is a cream?
Semisolid emulsion of oil in water
Contains emulsifier and preservative
High water content making it cooling and moisturising
Non-greasy and easy to apply making it cosmetically accceptable
What is an ointment?
Semisolid grease/oil (soft paraffin) No preservative Occlusive and emollient Restric transepidermal water loss Greasy
What is the downside to no presevative?
Can get contaminated with bacteria
What is a lotion?
Liquid formulation
Suspension or solution of medication in water, alcohol or other liquids
Alcohol may sting
Treat scalp, hair-bearing areas
What is a gel?
Thickened aqueous lotion
Semi-solid, containing high molecular weight polymers
Treat scalp, hair bearing areas, face
What is a paste?
Semisolid
Contains finely powdered material such as zinc
Stiff, greasy and difficult to apply
Protective, occlusive and hydrating
Often used in cooling, drying and soothing bandages
What is a foam?
Colloid with 2/3 phases
Usually hydrophilic liquid in continous phase with foaming agent dispersed in gaseous phase
Increased penetration of active agents
Can spread easily over large areas of skin
What are the different types of topical therapies?
Emollients Topical steroids Antiinfective agents Antipruritics Keratolytics Psoriasis therapies
What is an emollient?
Enhances rehydration of epidermis
For all dry/scaly conditions
When is wet wrap therapy used?
For exrotic skin
What is the mode of action of topical corticosteroids?
Vasoconstrictive
Anti-inflammatory
Antiproliferative
What is a mild steroid?
1% hydrocortisone
What is a moderate steroid?
0.05% clobetasone butryate
What is a potent steroid?
0.1% betamthasone valerate
What is a very potent steroid?
0.05% clobetasol proprironate
When are topical corticosteroids used?
Eczema
Psoriasis
Other non-infectiev inflammatory dermatosis
Keloid scars
What are some side effects of steroids?
Thinning of skin, purpura and stretch marks Steroid rosacea Perioral dermatitis May worsen or mask infections Systemic absorrption (cushings) Tahcyphlaxis Rebound flare
When are antiseptics used?
Recurrent infections
Antibiotic resistance
Wound irrigation
What are some common viruses that affect the skin?
Herpes simplex
Eczema herpeticum
Herpes zoster
What is the treatment for candidia?
Antiyeast - nystatin or clotrimazole
What is the treatment for dematophytes (ringworm)?
Antifungal - clotrimazole or terbinafine cream
What is the treatment for pityriasis versicolor?
Ketoconazole
What are some examples antipruritics?
Menthol
Capsaicin
Camphor/ phenol
Crotamiton
What is a keratolytic?
Used to soften keratin
When are keratolytics used?
Viral warts
Hyperkeratotic eczema and psoriasis
Corns and calluses
To remove keratin plaques in scalp
How are warts treated?
Keratolytics - salicyclic acid Formaldehyde Glutaraldehyde Silver nitrate Cryotherapy Podophyllin (genital warts)
What are some topical treatments for psoriasis?
Coal tar Vitamin D analogue Keratolytic Topical steroid Dithranol
How is scalp psoriasis treated?
Greasy ointment to soften scale
Tar shampoo
Steroids in alcohol base or shampoo
Vitamin D analogues
How is psoriasis in the axilla treated?
Topical steroids for face, flexures and groin/ genitals
Consider combo of antibacterial, antifunal
Calcineurin inhibitors
What are some side effects of topical therapies?
Burning or irritation
Contact allergic dermatitis
Local toxicity
Systemic toxicity
